Social Prescribing- Creating a Universal Offer Jane Hartley NE Social Prescribing Facilitator - NHSE & Health & Wellbeing Associate - VONNE

A connected society: a strategy for tackling loneliness ‘The practice known as ‘social prescribing’ will allow GPs to direct patients to community workers offering tailored support to help people improve their health and wellbeing, instead of defaulting to medicine.’ ‘GPs in England will be able to refer patients experiencing loneliness to community activities and voluntary services by 2023’ Theresa May Oct 2018

What is Social Prescribing Social prescribing connects people to community groups and services through the support of ‘link workers’, who give people time and co-produce a plan to meet the person’s health and wellbeing needs based on ‘what matters to me’.

The High Impact Action: Social Prescribing Why Social Prescribing? Reduces pressure on General Practice and A&E Improves support for people with wider ‘social’ needs Reduces health inequalities – for those who use the NHS the most, complex needs

Impact On the NHS: On GP consultation rates, A&E attendance, hospital stays, medication use, social care. University of Westminster led an evidence review, looking at the impact of social prescribing on demand for NHS Healthcare. Average of 28% less GP consultations & 24% less A&E attendances, where social prescribing ‘connector’ services are working well. https://www.westminster.ac.uk/patient-outcomes-in-health- research-group/projects/social-prescribing-network

Personalised Care and the NHS Long Term Plan

NHS Long Term Plan commitments Overview, p6: Within five years over 2.5 million more people will benefit from ‘social prescribing’, a personal health budget, and new support for managing their own health in partnership with patients' groups and the voluntary sector. 1.4, p25: Through social prescribing the range of support available to people will widen, diversify and become accessible across the country. Link workers within primary care networks will work with people to develop tailored plans and connect them to local groups and support services. Over 1,000 trained social prescribing link workers will be in place by the end of 2020/21 rising further by 2023/24, with the aim that over 900,000 people are able to be referred to social prescribing schemes by then.

Personalised Care Operating Model WHOLE POPULATION when someone’s health status changes 30% OF POPULATION People with long term physical and mental health conditions Cohorts proactively identified on basis of local priorities and needs Shared Decision Making People are supported to a) understand the care, treatment and support options available and the risks, benefits and consequences of those options, and b) make a decision about a preferred course of action, based on their personal preferences and, where relevant, utilising legal rights to choice (All tiers) Personalised Care and Support Planning People have a proactive, personalised conversation which focuses on what matters to them, delivered through a six-stage process and paying attention to their clinical needs as well as their wider health and wellbeing. LEADERSHIP, CO- PRODUCTION AND CHANGE ENABLER FINANCE ENABLER Review A key aspect of the personalised care and support planning cycle. Check what is working and not working and adjust the plan (and budget where applicable) Social Prescribing and Community-Based Support Enables professionals to refer people to a ‘link worker’ to connect them into community-based support, building on what matters to the person and making the most of community and informal support (All tiers) Supported Self Management Support people to develop the knowledge, skills and confidence (patient activation) to manage their health and wellbeing through interventions such as health coaching, peer support and self-management education (Targeted and Specialist) Personal Health Budgets and Integrated Personal Budgets An amount of money to support a person’s identified health and wellbeing needs, planned and agreed between them and their local CCG. May lead to integrated personal budgets for those with both health and social care needs (Initially Specialist) WORKFORCE ENABLER COMMISSIONING AND PAYMENT ENABLER Optimal Medical Pathway

Map all social prescribing connector schemes across England NHSE Objectives Map all social prescribing connector schemes across England Publish Summary Social Prescribing Guide alongside the Long Term Plan Launch an online social prescribing platform - Join by emailing england.socialprescribing@nhs.net Develop regional social prescribing networks and regional steering groups Publish Common Outcomes Framework for social prescribing Pilot new accredited learning programmes for social prescribing link workers April 19- 1 link worker for every PCN – up to 5 per network by 2028

Where can we find more information? A Social Prescribing Summary Guide will be published by NHS England in January 2019 NHS England has set up an online learning platform to share the latest resources. To join the platform, please contact england.socialprescribing@nhs.net

What will this mean for local areas? Primary Care Networks should work collaboratively with their CCGs, local authorities and VCSE partners to create a shared local social prescribing plan which: Builds on existing social prescribing schemes where possible Embeds link workers in PCN multi-disciplinary teams, extending access to social prescribing Provide local funding and development support to the VCSE sector and community groups, who receive social prescribing referrals

A model for social prescribing

Social Prescribing Connector Scheme NHS England wants every local area to have a social prescribing connector scheme, which enables all GPs to refer people with wider needs. Referrals to Link Workers Link workers give people time, co-produce support plans and practically connect people to community groups, services and support Ideally hosted in VCSE sector, commissioned by CCGs/ LA’s

The VCSE supporting health & wellbeing and tackling inequalities No wrong door -The sector’s strength lies in its holistic, community-embedded and personalised approaches. Track record of trust – local people trust us! VCSE organisations promote understanding of the specific needs of their communities. Its diversity, flexibility and level of innovation helps it reach and support those hardest to engage Builds emotional resilience and promotes self-care and independence Facilitate asset based approaches and co-production Expertise of lived experience in designing more effective, sustainable services These are the findings of Joint review of role of the VCSE sector in improving health, wellbeing and care outcomes & partnerships Commissioned by the Department of Health, Public Health England, and NHS England in March 16

The High Impact Action: Social Prescribing Models 1. Referral to a commissioned ‘one-stop connector service’ 2. Collaborative Practices: GP surgeries as community ‘hubs’, invite citizens in to work collaboratively, as ‘health champions’. 3. In-house ‘navigators’ – employed by GP Practices. 4. Active Signposting: ‘Care Navigators’ in GP practices, having different conversations with patients, signposting them to community support, as well as pharmacy, physiotherapists and care providers. Referral Agency: GP, Integrated Care team, social care, , VCSE, Emergency services, self referral Connector: Community navigator or ‘link worker’, employed in the VCSE sector Prescription: Community Groups - gardening, singing, dance, debt advice ,peer support – funded

Link workers are distinct from care navigators. Social prescribing link workers are employed specifically to: give time to people with wider social needs; who may be lonely or isolated, need help with their mental health, multiple long- term conditions or have complex issues which impact on their wellbeing focus on ‘what matters to you’ work with what motivates them create a simple shared plan with the person connect people with community groups and agencies, for practical and emotional support where needed - home visits and taking people to groups for the first time where people don’t have the confidence to make their own connections.

Social Prescribing Activities Often delivered by smaller community groups at neighbourhood level THE VCSE at local level requires funding to sustain and to absorb increased demand via social prescribing

North East Voluntary Sector Highly Localised Focus – neighbourhood level Often acting as the ‘glue’ for local communities running community activities and services Large proportion of smaller VCS orgs - 50K or less Few larger orgs locally Asset poor Historically heavily dependent on public sector funding – particularly smaller/medium orgs Inequalities across geography of NE

What Social Prescribing means to patients ‘Before social prescribing I was very isolated, shut off from the world, struggling to leave the house, lost , helpless battling every day to keep going. Nothing to live for, nothing to get up for, nothing to get ready for, nothing to do, nowhere to go. There’s no point in being stuffed full of tablets if you have no purpose in life, this has given me a light to my life. Kerching!’

Aims and Overview of Networks National Social Prescribing Network (hosted by the University of Westminster) and NHS England Social Prescribing Team driven the establishment of: Regional Social Prescribing Networks across England To create a supportive network of collaborators who can work together, share good practice, learn from each other and be part of building the social prescribing movement across health and wellbeing. NE Social Prescribing Network Conference Thursday 14th March bringing together people from health, local government and voluntary, community and social enterprise sectors to continue the conversation, explore the benefits of social prescribing and plan how to spread social prescribing everywhere

Social Prescribing Day 14th March Join the conversation SocialPrescribingDay

Resources jane.hartley@vonne.org.uk National Social Prescribing Network email: socialprescribing@outlook.com https://www.westminster.ac.uk/social-prescribing-network NHS England – On Line platform & register for events & membership of NE Social Prescribing Network Email: england.socialprescribing@nhs.net Jane Hartley- NE Regional Social Prescribing Facilitator jane.hartley@vonne.org.uk